Provider Demographics
NPI:1972098333
Name:DAVIS, DANETTE LYNN (PHARM D)
Entity type:Individual
Prefix:
First Name:DANETTE
Middle Name:LYNN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 SE PARKWAY STE 170
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-3962
Mailing Address - Country:US
Mailing Address - Phone:615-591-1101
Mailing Address - Fax:
Practice Address - Street 1:145 SE PARKWAY STE 170
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3962
Practice Address - Country:US
Practice Address - Phone:615-591-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-28
Last Update Date:2018-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN99933336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy